PDAs Help Pharmacists Deliver The Best Care, Anywhere

MARCH 01, 2007

Wendy K. Bodine, Assistant Editor

Pharmacists are busier than ever
today, and they need to stay on
top of the latest technological
advances in order to keep up with
increasing patient demands. One of
these advances is the ability to track
patients' medical information online
from any location using personal digital
assistants (PDAs). This capability is
essential when dealing with high-risk
patients, when medication changes
may need to occur quickly at any time.

Thomson Healthcare (Greenwood
Village, Colo) has set out to meet the
needs of the modern pharmacist with
innovative software solutions. William
Lawson, MD, vice president of
client solutions, discussed the
benefits of working with Thomson
Healthcare.

"The technologies and solutions
that we provide to hospital pharmacies
are just as valuable in the
retail setting," Dr. Lawson said. "In
the hospital, we provide detailed
drug information, drug-interaction
alerts and tools, patient-education
information, mobile/PDA access to
all our referential content, and
even pill-identification tools."

"These same solutions are being
introduced to the retail pharmacist?
with the same goal of providing the
best evidence-based clinical information
at the point of care," he added.
"The goal is to automate repetitive
manual processes and free up
the?pharmacist to be more of a
hands-on clinician and less of a bookkeeper."

One of Thomson Healthcare's newest
advances is the Medication Reconciliation
Solution, a Web-based
interface that simplifies the process of
collecting and monitoring patients'
medication lists from the time they are
admitted until they are discharged. The
system integrates data from local community
pharmacies, insurance companies,
and previous hospital visits to
compile a comprehensive list of a
patient's current medication profile.

At each stage of a patient's treatment,
caregivers can choose to continue,
discontinue, or modify the dosages
of current medications or add other
medications by way of a visual reconciliation
process. When the patient is discharged,
medication orders can be sent
directly to the patient's home pharmacy
and to his or her primary care
provider.

The Medication Reconciliation Solution
helps manage a patient's medication
list through a number of features.
The system keeps an electronic list of
the patient's current home medications
and automatically checks for allergies,
duplications, interactions, and warnings
when new medications are ordered. If a
patient does not know the name of his
or her medicine but can describe it, the
system has a drug-identification tool
that provides images, descriptions, and
imprint codes to aid in establishing the
identity of mystery drugs. The application
is linked directly to comprehensive
evidence-based drug information from
Thomson Healthcare.

The Pharmacy Interventions Solution
from Thomson Healthcare applies technology
to allow the hospital pharmacist
to automatically identify at-risk patients
most in need of interventions and then
puts all clinical data within the pharmacist's
reach at the point of care. It provides
the pharmacist with desktop and
handheld access to up-to-date patient
data (medications, demographics, laboratory
results, and reports) and to clinical
reference data. In addition, it offers
a tracking tool for monitoring the
progress and results of all the interventions
initiated by the pharmacy.

The Formulary Advisor Solution
eliminates the need to enter formulary
updates manually. Everything
is done online, so that the
formulary manager can spend less
time administering and communicating
changes. The pharmacist on
rounds can get online and handheld
PDA access to the up-to-date
formulary with links back into the
DRUGDEX System (a Thomson
Healthcare referential content
product) for more detailed information.
Pharmacists who use the
Formulary Advisor show less time
spent on administration and confirming
which drugs are or are not on the formulary
and, ultimately, more time spent
with patients?resulting in better
patient care.

Another company that is working to
help pharmacists help their patients
better is Lexi-Comp Inc. Based in
Hudson, Ohio, the company was founded
to create custom reference handbooks
for clinical laboratories. It has
since expanded its content base and
technology solutions to provide real-time information at the point
of care in
knowledge areas that include pharmacology,
interactions, diagnostic procedures
and laboratory tests, pharmacogenomics,
poisoning and toxicology,
dentistry, infectious diseases, and patient
education.

Information is delivered on a variety
of electronic platforms. They include
Lexi-Comp ON-LINE, ON-HAND, ONDESKTOP,
and ON-WEB. All of these
platforms can be integrated for hospitals
and health systems through the
Lexi-Comp Knowledge Solution.

"Lexi-Comp ON-LINE uniquely integrates
industry-leading databases and
enhanced searching technology to
deliver time-sensitive clinical information
at the point of care," said Daniel
Krinsky, MS, RPh, Lexi-Comp's director
of corporate training and development.
"The interface eliminates the need to
navigate through multiple pages or
make unnecessary mouse clicks."

Lexi-Comp ON-LINE provides access
to drug-information databases, an interactions-
analysis application, patient
advisory leaflets for drugs and disease
states, a drug-identification program, a
medical-calculations module, and many
other features.

Lexi-Comp ON-HAND delivers very
similar content to what is offered
online, but through various mobile
devices with Palm OS, Pocket PC, and
BlackBerry operating systems.

The company's most comprehensive
drug database is Lexi-Drugs, an easy-touse
record of more than 1600 drug
monographs supporting over 8000 US
and Canadian medications. Its content
addresses many patient populations
and clinical specialties such as pharmacy,
internal medicine, cardiology, oncology,
psychiatry, and anesthesiology. The
monographs provide up to 55 fields of
information, among them adverse reactions,
US and Canadian brand names,
contraindications, dosing, special alerts
(including new FDA warnings), medication-
safety issues, pharmacodynamics/
kinetics, and brand names from >75
countries.

Another key database is Lexi-
Interact, a tool for checking patient profiles
for drug, food, herbal, and alcohol
interactions. This program performs an
analysis of a patient's entire drug and
natural-product profile to identify
potential interactions. Fully referenced
and evidence-based, this application
facilitates a patient-specific risk-to-benefit
assessment. Analysis results offer a
detailed overview of the interactions,
with fields such as risk rating, patient
management, class exceptions, discussion,
and references.

Lexi-Comp ON-DESKTOP is a comprehensive
collection of the company's
medical-reference databases and integrated
modules. Shipped to subscribers
on a single CD-ROM for Microsoft Windows
or Mac OS, ON-DESKTOP provides
instant access to >70,000 pages of current
clinical information in a concise
and easy-to-read format. Users point
and click to find answers regarding
diagnosis, treatment, and other clinical
decisions.

A subscription to ON-DESKTOP includes
1-click updates through the
Internet during the subscription period.
The benefit of this platform is that
access does not require continuous
Internet connectivity; users can download
updates when connectivity is
available. This is an ideal solution for
consultant pharmacists and those who
use a laptop with inconsistent Internet
access.

Lexi-Comp provides daily updates to
its drug monographs through continuous
peer review that includes consultants
and reviewers from client hospitals,
135 outside authors, and an onstaff
team of pharmacists. The
Knowledge and Academic Solutions are
used at hundreds of institutions, and
the ON-HAND software is utilized by
thousands of clinicians throughout the
world. Lexi-Comp also publishes a comprehensive
handbook library of more
than 40 reference titles, including the
Drug Information Handbook, the
Pediatric Dosage Handbook, and the
Geriatric Dosage Handbook.

Both Thomson Healthcare and Lexi-Comp are dedicated to providing
pharmacists
with the newest software to
help them stay abreast of all the medication
requirements of their patients.
With the aid of modern medicationinformation
systems, pharmacists can
keep up with their patients' needs as
quickly as they arise.